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Bill· HRH.R. 2049 (94th)referred
United States · United States Congress · 23 January 1975
National Comprehensive Health Benefits Act - Requires a health maintenance organization to have a fiscally sound operation or carry insurance which protects its members against the risk of its becoming insolvent. Requires a health maintenance organization to provide basic and supplemental health services to its members. Defines "basic health services" as: (1) physician services (including consultant and referral services by a physician); (2) in-patient and out-patient hospital services; (3) diagnostic laboratory and diagnostic and therapeutic radiologic services; (4) mental health services, up to forty-five ambulatory visits or sessions under a program for the treatment of mental illness, alcoholism, or problems of drug abuse and drug dependence, and twenty-one in-patient hospital days per year; (5) home health services; and (6) preventive health services (including preventive dental care for children and children's eye examinations conducted to determine the need for vision correction). Defines "supplemental health services" as: (1) services of facilities for long-term care; (2) vision care not included under basic health services; (3) dental services not included under basic health services; (4) mental health services in excess of those specified under basic health services; (5) physical medicine and rehabilitative services (including physical therapy); and (6) prescription drugs. States that coverage of a member of a health maintenance organization for Comprehensive Health Care Benefits shall entitle the member to have the carrier pay, in accordance with this Act but subject to the limitations of this Act the approved predetermined charges of the health maintenance organization of which he is a member for services and items furnished to him and covered by such benefits, or the charges of another health maintenance organization or provider that furnished to him medically necessary covered services or items. Provides that such coverage is subject to the carrier's right to reimbursement from the member in the amount of the copayments (if any) payable under this Act, and subject to the other provisions of this Act. Defines the term "comprehensive health care benefits" to consist of benefits for ambulatory services, inpatient services, and catastrophic expense benefits. Provides that, except to the extent that health maintenance organizations operate on a predetermined prepayment charge basis and do not impose separate charges for services and other items covered by Comprehensive Health Care Benefits at the time such services and items are furnished to a covered individual, and except when Catastrophic Expense Benefits are in effect, coverage for Comprehensive Health Care Benefits is subject to the payment, by the covered individual or on his behalf by another person or agency, of copayments in the case of services or items with respect to which copayments are specified, but only if the individual is not a low-income person or a member of a low-income family. Requires the Secretary of Health, Education, and Welfare to issue appropriate regulations. Requires every person who is an employer within the meaning of title II of the Social Security Act (Federal Old Age, Survivors, and Disability Insurance Benefits) to provide benefits at least equivalent to "basic health services" to each employee and the members of such employee's family. Allows the Secretary to partially reimburse employers for their contribution under certain circumstances. Provides that the Secretary of Labor, in accordance with regulations prescribed in consultation with the Secretary of Health, Education, and Welfare, shall purchase such coverage for, and determine the methods by which (and the terms and conditions under which) it is to be made available to, unemployed individuals and family members. States that every individual who is a resident of the United States shall be entitled to coverage for comprehensive health care benefits. Establishes various income classes for the purposes of determining amounts of premium contributions. Defines the term "carrier" for purposes of comprehensive health care benefits and requires carriers to participate under State plans. States that each contract with a carrier under this Act, including contracts with health maintenance organizations qualifying as carriers and contracting with respect to their members, shall require the carrier to make such reports, in such form, and containing such information as the Secretary or his agents (including participating State health commissions) may require to carry out their functions under this Act and to keep such records and afford such access thereto as the Secretary or his agents may find necessary to assure the correctness and verification of the reports and otherwise to carry out its functions under this Act. Declares that States will be in compliance with this Act, if, and only if: (1) the State has accepted the provisions of this Act and created, as a newly constituted and independent establishment within the executive branch of the State government, a State agency for carrying out the responsibilities devolving upon the State under this Act headed by a multimember governing body hereinafter in this Act referred to as the 'State Health Commission' and has vested in such agency the necessary exclusive authority on behalf of the State; (2) there has been established in that agency a State Advisory Council; and (3) the Secretary has approved a State plan. Provides that the Advisory Council to the State Health Commission of a State shall consult with the commission in the development and implementation of a State plan. Specifies the necessary components of a State plan. Sets forth the regulatory functions of State health commissions. Permits the Federal exercise of State functions in cases of noncompliance by States. Charges the Secretary with responsibility for the planning, administration, operation, coordination, and evaluation of the health care program under this Act. Directs the Secretary to prescribe such regulations as he deems necessary to the efficient administration of this Act. Establishes a National Health Services Advisory Council to: (1) advise the Secretary on matters of general policy in the administration of this Act and in the formulation of regulations; and (2) study the operation of this Act and the activities of State Health Commissions, health maintenance organizations, and other providers, with a view to recommending any changes in the administration of this Act or in its provisions which may appear desirable. Requires the Council to make an annual report to the Secretary on the performance of its functions, and the Secretary shall transmit the report to the Congress, together with a report by the Secretary on any administrative recommendations of the Council which have not been followed, and a report by the Secretary of his views with respect to any legislative recommendations of the Council. Provides that the Secretary shall, through contracts with carriers, provide the prepaid coverage for the benefits to which aged, low-income, and certain other individuals and their families are entitled under this Act. Declares it to be one of the purposes of this Act to establish the responsibility of the Secretary to encourage, promote, and assist the establishment, as soon as practicable, of the comprehensive health care delivery system contemplated by this title, by providing financial and technical assistance for studying the feasibility of, and for the planning, development, and initial operation of health maintenance organizations, including incentives for the development and improvement of ambulatory care centers, particularly in poverty and rural areas. Directs the National Health Services Advisory Council to conduct a full and complete study and investigation of methods for supplying supplemental capital and other funding for health maintenance organizations and other health care providers in the United States, with the objective of developing a national program for supplying such funding, giving special emphasis to areas of high priority health care needs both rural and urban, which will effectively carry out the purpose of this Act. Sets forth the effective dates of this Act.
Bill· HRH.R. 2050 (94th)referred
United States · United States Congress · 23 January 1975
National Comprehensive Health Benefits Act - Requires a health maintenance organization to have a fiscally sound operation or carry insurance which protects its members against the risk of its becoming insolvent. Requires a health maintenance organization to provide basic and supplemental health services to its members. Defines "basic health services" as: (1) physician services (including consultant and referral services by a physician); (2) in-patient and out-patient hospital services; (3) diagnostic laboratory and diagnostic and therapeutic radiologic services; (4) mental health services, up to forty-five ambulatory visits or sessions under a program for the treatment of mental illness, alcoholism, or problems of drug abuse and drug dependence, and twenty-one in-patient hospital days per year; (5) home health services; and (6) preventive health services (including preventive dental care for children and children's eye examinations conducted to determine the need for vision correction). Defines "supplemental health services" as: (1) services of facilities for long-term care; (2) vision care not included under basic health services; (3) dental services not included under basic health services; (4) mental health services in excess of those specified under basic health services; (5) physical medicine and rehabilitative services (including physical therapy); and (6) prescription drugs. States that coverage of a member of a health maintenance organization for Comprehensive Health Care Benefits shall entitle the member to have the carrier pay, in accordance with this Act but subject to the limitations of this Act the approved predetermined charges of the health maintenance organization of which he is a member for services and items furnished to him and covered by such benefits, or the charges of another health maintenance organization or provider that furnished to him medically necessary covered services or items. Provides that such coverage is subject to the carrier's right to reimbursement from the member in the amount of the copayments (if any) payable under this Act, and subject to the other provisions of this Act. Defines the term "comprehensive health care benefits" to consist of benefits for ambulatory services, inpatient services, and catastrophic expense benefits. Provides that, except to the extent that health maintenance organizations operate on a predetermined prepayment charge basis and do not impose separate charges for services and other items covered by Comprehensive Health Care Benefits at the time such services and items are furnished to a covered individual, and except when Catastrophic Expense Benefits are in effect, coverage for Comprehensive Health Care Benefits is subject to the payment, by the covered individual or on his behalf by another person or agency, of copayments in the case of services or items with respect to which copayments are specified, but only if the individual is not a low-income person or a member of a low-income family. Requires the Secretary of Health, Education, and Welfare to issue appropriate regulations. Requires every person who is an employer within the meaning of title II of the Social Security Act (Federal Old Age, Survivors, and Disability Insurance Benefits) to provide benefits at least equivalent to "basic health services" to each employee and the members of such employee's family. Allows the Secretary to partially reimburse employers for their contribution under certain circumstances. Provides that the Secertary of Labor, in accordance with regulations prescribed in consultation with the Secretary of Health, Education, and Welfare, shall purchase such coverage for, and determine the methods by which (and the terms and conditions under which) it is to be made available to, unemployed individuals and family members. States that every individual who is a resident of the United States shall be entitled to coverage for comprehensive health care benefits. Establishes various income classes for the purposes of determining amounts of premium contributions. Defines the term "carrier" for purposes of comprehensive health care benefits and requires carriers to participate under state plans. States that each contract with a carrier under this Act, including contracts with health maintenance organizations qualifying as carriers and contracting with respect to their members, shall require the carrier to make such reports, in such form, and containing such information as the Secretary or his agents (including participating State health commissions) may require to carry out their functions under this Act and to keep such records and afford such access thereto as the Secretary or his agents may find necessary to assure the correctness and verification of the reports and otherwise to carry out its functions under this Act. Declares that States will be in compliance with this Act, if, and only if: (1) the State has accepted the provisions of this Act and created, as a newly constituted and independent establishment within the executive branch of the State government, a State agency for carrying out the responsibilities devolving upon the State under this Act headed by a multimember governing body hereinafter in this Act referred to as the 'State Health Commission' and has vested in such agency the necessary exclusive authority on behalf of the State; (2) there has been established in that agency a State Advisory Council; and (3) the Secretary has approved a State plan. Provides that the Advisory Council to the State Health Commission of a State shall consult with the commission in the development and implementation of a State plan. Specifies the necessary components of a State plan. Sets forth the regulatory functions of state health commissions. Permits the Federal exercise of State functions in cases of noncompliance by States. Charges the Secretary with responsibility for the planning, administration, operation, coordination, and evaluation of the health care program under this Act. Directs the Secretary to prescribe such regulations as he deems necessary to the efficient administration of this Act. Establishes a National Health Services Advisory Council to: (1) advise the Secretary on matters of general policy in the administration of this Act and in the formulation of regulations; and (2) study the operation of this Act and the activities of State Health Commissions, health maintenance organizations, and other providers, with a view to recommending any changes in the administration of this Act or in its provisions which may appear desirable. Requires the Council to make an annual report to the Secretary on the performance of its functions, and the Secretary shall transmit the report to the Congress, together with a report by the Secretary on any administrative recommendations of the Council which have not been followed, and a report by the Secretary of his views with respect to any legislative recommendations of the Council. Provides that the Secretary shall, through contracts with carriers, provide the prepaid coverage for the benefits to which aged, low-income, and certain other individuals and their families are entitled under this Act. Declares it to be one of the purposes of this Act to establish the responsibility of the Secretary to encourage, promote, and assist the establishment, as soon as practicable, of the comprehensive health care delivery system contemplated by this title, by providing financial and technical assistance for studying the feasibility of, and for the planning, development, and initial operation of health maintenance organizations, including incentives for the development and improvement of ambulatory care centers, particularly in poverty and rural areas. Directs the National Health Services Advisory Council to conduct a full and complete study and investigation of methods for supplying supplemental capital and other funding for health maintenance organizations and other health care providers in the United States, with the objective of developing a national program for supplying such funding, giving special emphasis to areas of high priority health care needs both rural and urban, which will effectively carry out the purpose of this Act. Sets forth the effective dates of this Act.
Bill· HRH.R. 1969 (94th)referred
United States · United States Congress · 23 January 1975
Authorizes under the provisions of the Public Health Service Act the Secretary of Health, Education, and Welfare to provide epileptics medicine for the treatment of epilepsy. Authorizes appropriations of such sums as may be necessary to carry out the provisions of this Act.
Bill· HRH.R. 1943 (94th)referred
United States · United States Congress · 23 January 1975
Provides for inclusion of the services of licensed (registered) nurses under the medicare and medicaid, titles XVIII and XIX of the Social Security Act.
Bill· HRH.R. 1901 (94th)referred
United States · United States Congress · 23 January 1975
New American Health Services Act - Authorizes the Secretary of Health, Education, and Welfare to make grants to the individual States for the purpose of insuring high quality comprehensive health services for immigrants residing in the United States through the establishment and support of: (1) health services projects; (2) counseling and educational programs; and (3) related evaluation efforts. Requires each State to submit a formal State plan for the provision of health services to immigrants to the Secretary for approval. Sets forth requirements to be met by State plans. States that the Secretary shall not finally disapprove a State plan except after reasonable notice and opportunity for a hearing to the States. Stipulates that in making grants under this Act, priority shall be given to those applicants who demonstrate a capability to provide preventive health services such as, but not limited to: (1) dental services; (2) family planning services; (3) home health services; (4) nutritional services; (5) public health nursing services; and (6) vision services. Authorizes appropriations for the purpose of carrying out this Act, $50,000,000 for fiscal year ending June 30, 1976, $70,000,000 for the fiscal year ending June 30 1977, and $80,000,000 for the fiscal year ending June 30, 1978.
Bill· HRH.R. 1902 (94th)referred
United States · United States Congress · 23 January 1975
Bilingual Health Opportunities Act - Authorizes appropriations for fiscal year 1974 and each of the three succeeding fiscal years of such sums as may be necessary to establish up to four bilingual health training clinical centers in communities where a substantial proportion of the residents is of limited English-speaking ability. Directs the Secretary of Health, Education, and Welfare to arrange for the conduct of a study or studies to determine the effectiveness of health education institution admissions examinations in evaluating accurately the potential and ability of the student applicant of limited English-speaking ability to participate in and benefit from the educational program, taking into account the need to eliminate any cultural bias in the presentation of admissions examinations.
Bill· HRH.R. 1876 (94th)referred
United States · United States Congress · 23 January 1975
Provides, under title XVIII (Medicare) and title II (Old-Age, Survivors' and Disability Insurance) of the Social Security Act, that eligible drugs, requiring a physicians prescription or certification, shall be included among the items and services covered under the hospital insurance program for the aged at a specified amount of payment. States that the reasonable allowance for eligible drugs furnished an individual pursuant to any one prescription and purchased by such individual at any one time shall be reduced by an amount equal to the applicable prescription copayment obligation which shall be $1. Establishes, within the Department of Health, Education, and Welfare, a Medicare Formulary Committee to compile and publish a Formulary listing the drugs deemed qualified for benefits under this Act, together with maximum allowable costs and additional information concerning such drugs. Makes provisions for selecting drugs for the Formulary.
Bill· HRH.R. 1877 (94th)referred
United States · United States Congress · 23 January 1975
Authorizes the payment under the supplementary medical insurance program of title XVIII (Medicare) of the Social Security Act for annual comprehensive physical examinations.
Bill· HRH.R. 1834 (94th)referred
United States · United States Congress · 23 January 1975
Authorizes payment under the supplementary medical insurance program, of title XVIII (Medicare) of the Social Security Act, for annual immunization against influenza.
Bill· HRH.R. 1815 (94th)referred
United States · United States Congress · 23 January 1975
Health Security Act - Title I: Health Security Benefits - Provides that every resident of the U.S. (and every non-resident citizen when in the U.S.) will be eligible for covered services. Permits reciprocal and "buy-in" agreements for groups or non-resident aliens, and in some cases benefits to U.S. residents when visiting in other countries. Entitles every eligible person to have payments made by the Health Security Board for covered services provided within the United States by a participating provider. Provides that all necessary professional services of physicians, wherever furnished are covered, including preventive care, with two restrictions: (1) specialist services are covered only when performed by a qualified specialist except in emergency situations, and generally only on referral from a primary physician; and (2) psychiatric services to an ambulatory patient are covered only for active preventive, diagnostic, therapeutic or rehabilitative service with respect to mental illness. Provides that comprehensive dental services (exclusive of most orthodontic services) are covered for children under age 15, with the covered age group increasing by two years each year until all those under age 25 are covered. Provides that: (1) inpatient and outpatient hospital services and services of a home health agency are covered without arbitrary limitation; and (2) pathology and radiology services are specifically included as parts of institutional services. Limits payment for skilled nursing home care to 120 days per spell of illness, except that this limit may be increased when the nursing home is owned or managed by a hospital and payment for care is made through the hospital budget. Limits the psychiatric hospital benefit to 45 consecutive days of active treatment during a spell of illness. Provides coverage for two categories of drug use: prescribed medicines administered to inpatients or outpatients within participating hospitals; or to enrollees of comprehensive health service organizations, and drugs necessary for the treatment of specified chronic illnesses or conditions requiring long or expensive therapy. Requires the Board and the Secretary of Health, Education, and Welfare to establish two lists of approved drugs, taking into account the safety, efficacy and cost of each drug. Provides a broad list of approved medicines available for use in institutions and by comprehensive health service organizations and a more restricted list which is available for use outside such organized settings. Provides that the appliances benefit is similar in concept and operation to the drug benefit, subject to a limitation on aggregate cost. Asserts that the professional services of optometrists and podiatrists are covered, subject to regulations, as are diagnostic or therapeutic services furnished by independent pathology laboratories and radiology services. States that health services furnished or paid for under a workmen's compensation law are not covered. Provides that the services of a professional practitioner are not covered if they are furnished in a hospital which is not a participating provider. Requires that participating providers meet standards established in this title or by the Board. Requires that such providers must agree to provide services without discrimination, to make no unauthorized charge to the patient for any covered service, and to furnish data necessary for utilization review by professional peers, statistical studies by the Board, and verification of information for payments. Makes professional practitioners licensed when the program begins eligible to practice in the State where they are licensed and requires that all newly licensed applicants for participation meet national standards established by the Board in addition to those required by his State. Establishes conditions of participation for general hospitals similar to those required by Medicare. States that the two requirements not found in the Medicare program are: (1) that the hospital must not discriminate in granting staff privileges on any grounds unrelated to professional qualifications, and (2) that it establish a pharmacy and drug therapeutics committee for supervision of hospital drug therapy. Provides that psychiatric hospitals will be eligible to participate only if the Board finds that the hospital (or a distinct part of the hospital) is engaged in furnishing active diagnostic, therapeutic and rehabilitative services to mentally ill patients. Establishes conditions of participation for skilled nursing homes similar to those established for extended care facilities under Medicare. Makes provisions for the participation of home health service agencies. Describes as eligible a health maintenance organization which undertakes to provide an enrolled population either with complete health care or, at least, with complete health security services (other than institutional services, mental health or dental services) for the maintenance of health and the care of ambulatory patients. Permits a foundation sponsored by a county or other local medical society to participate as a provider of services. Permits the participation of community health centers or the like which, though furnishing services as comprehensive as are required by this Act, do not serve an enrolled or otherwise predetermined population and may not meet other requirements of this Act. Authorizes the Board to deal separately with the primary care portion of a system of comprehensive health care where it is necessary to rely on arrangements with other providers. Permits the Board to contract directly with public or other nonprofit mental health centers and mental health day care services. Specifies the conditions under which independent pathology laboratories, independent radiological services, and providers of drugs, devices, appliances, equipment, or ambulance services may qualify as providers under Health Security. Requires that a participating skilled nursing home have in effect an agreement with at least one participating hospital for the transfer of patients and medical and other information as medically appropriate. Prohibits in malpractice judgments any damages to be awarded to the injured party for the cost of remedial services which he is entitled to receive under this Act. Excludes the institutions of the Department of Defense and the Veterans Administration, and institutions of the Department of Health, Education, and Welfare serving merchant seamen or Indians or Alaskan natives, from serving as participating providers, as well as any employee of these institutions when he is acting as an employee. Provides reimbursement for any services furnished by these institutions or agencies to eligible persons who are not a part of their normal clientele. Permits a physician, dentist, optometrist, or podiatrist, licensed in one State and meeting the national standards, to furnish Health Security benefits in any other State, the scope of his permissible practice being governed by the law of the State in which he is practicing. Grants a similar authority to other health professional and nonprofessional personnel. Establishes the Health Security Trust Fund, to receive the net assets of existing (Medicare) funds taken over by the Health Security program, the yield of the Health Security taxes, and the Government's contribution from general revenues amounting to 100 percent of the yield from these taxes. Provides that three separate accounts shall be established in the Health Security Trust Fund: a Health Service Account, a Health Resources Development Account, and an Administration Account. Provides that in each of the first two years of program operation, 2 percent of the Trust Fund shall be set aside for the Health Resources Development Fund; and the allocation shall increase by 1 percent at two-year intervals to 5 percent within the next 6 years. Provides for allocation of the Health Services account among the regions of the country. Provides that the allocation to each region shall be based on the aggregate sum expended during the most recent 12-month period for covered services (with appropriate modification for estimated changes in the consumer price index, the expected number of eligible beneficiaries, and estimated changes in the number of participating providers). Provides that the Board shall divide the allocation to each region into funds available to pay: institutional services; physician services; dental services; furnishing of drugs; furnishing of devices, appliances, equipment; and miscellaneous services. Provides that payments for covered services provided to eligible persons by participating providers will be made from the Health Service Account in the Trust Fund. Describes the method to be used in applying, as between practitioners electing the various methods of payment (fee-for-service and capitation), the monies available in each health service area for payment to each category of professional providers. Authorizes the Board to experiment with other methods of reimbursement so long as the experimental method does not increase the cost of service or lead to overutilization or underutilization of services. Provides that skilled nursing homes and home health agencies will be paid in the same manner as a general hospital (on an approved annual budget basis). Provides that a health organization will be paid for covered services, on the basis of a fixed capitation rate multiplied by the number of eligible enrollees. Contains a series of provisions for developing a continuous process of health service planning and for assisting in the recruitment, education, and training of health personnel. Authorizes special improvement grants: (1) to any public or other nonprofit health agency or institution to establish improved coordination and linkages with other providers of services, and (2) to organizations providing comprehensive ambulatory care, to improve their utilization review, budget, statistical, or records and information retrieval systems, to acquire equipment needed for those purposes, or to acquire equipment useful for mass screening or for other diagnostic or therapeutic purposes. Sets forth the responsibilities and duties of the Secretary of HEW and the Board with regard to this title. Creates an administrative structure within the Department of Health, Education, and Welfare with exclusive responsibility for the administration of the Health Security program. Establishes a five-member, full-time Health Security Board serving under the Secretary of Health, Education, and Welfare. Provides that the members shall be appointed by the President with the advice and consent of the Senate, for five-year overlapping terms. Creates the position of an Executive Director, appointed by the Board with the approval of the Secretary. Provides that the Executive Director will serve as secretary to the Board and shall perform such duties in the administration of the program as the Board may assign. Provides that the program will be administered through the regional offices of the Department of Health, Education, and Welfare. Requires the establishment of sub-regional (service area) offices. Establishes a National Health Security Advisory Council, with the Chairman of the Board serving as the Council's Chairman and 20 additional members not in the employ of the Federal Government. Authorizes the Advisory Council to appoint professional or technical committees to assist in its functions. Provides that the Advisory Council will advise the Board on matters of general policy in the administration of the program, the formulation of regulations and the allocation of funds for services. Charges the Board with responsibility for informing the public and providers about the administration and operation of the Health Security program. Requires the Board to make a continuing study and evaluation of the program, including adequacy, quality and costs of services. Authorizes the Board directly or by contract to make detailed statistical and other studies on a national, regional, or local basis of any aspect of the title; to develop and test incentive systems for improving quality of care, methods of peer review of drug utilization and of other service performances; to develop and test systems of information retrieval, budget programs, instrumentation for multiphasic screening or patient services, and reimbursement systems for drugs; and to make such other other studies which it considers would improve the quality of services of the administration of the program. Grants authority to the Board, in accordance with regulations, to make determinations of who are participating providers of services, determinations of eligibility, of whether services are covered, and the amount to be paid to providers. Allows a provider of services who is dissatisfied with a final Board determination to obtain a hearing before a Board panel, and judicial review of a final decision. Authorizes the Board, with the advice and assistance of the Commission on the Quality of Health Care, to issue and review regulations assuring the quality of care furnished under this Act. Requires continuing professional education by physicians, dentists, optometrists, and podiatrists. Provides for the appointment of a Deputy Secretary of HEW and an Under Secretary for Health and Science. States that no provision of this Act shall alter any contractual obligation of an employer to provide health services to his employees and their dependents. Title II: Health Security Taxes - Converts the existing Medicare hospital insurance payroll taxes into Health Security taxes, and raises the rates to 1 percent on employees and 3.5 percent on employers. Raises the wage base for the employee tax from the present $7,800 to $15,000; or, if higher, 125 percent of the contribution and benefit base. Broadens the definitions of covered employment to include foreign agricultural workers, employees of the U.S. and its instrumentalities (other than members of the armed forces and the President, Vice-President, and Members of Congress), employees of charitable and similar organizations, railroad employees, and (for the employee tax only) employees of States and their political subdivisions and instrumentalities. Excludes from the gross income of employees, for income tax purposes, payment by their employers of part or all of the Health Security taxes on the employees. Spells out the precise effective dates of the new payroll tax provisions. Converts the existing Medicare self-employment tax into a Health Security self-employment tax, raising the rate to 2.5 percent, and raises the maximum taxable self-employment income from $7,800 to $15,000. Adds a new 1 percent Health Security tax on unearned income (unless such income is less than $400 a year), subject to the same maximum on taxable income as is applicable to the employee and self-employment taxes. Title III: Commission on the Quality of Health Care - Establishes in the Department of HEW a Commission on the Quality of Health Care, with the primary responsibility of: (1) initiating and continuing development of methods of assessing the quality of health care furnished under the Health Security Act, and (2) submitting to the Secretary and the Health Security Board its findings and recommendations. Stipulates that in carrying out its duties the Commissioner shall emphasize, and give first consideration to, care furnished for those illnesses and conditions which have relatively high incidence in the population and which are relatively amenable to medical or other care. Title IV: Repeal or Amendment of Other Acts - Requires that after the effective date of benefits, no State shall be required to furnish any service covered under Health Security as a part of its State plan for participation under Medicaid. Title V: Studies Related to Health Security - Authorizes the Secretary of Health, Education, and Welfare in consultation with the Secretary of State and the Secretary of Treasury to study the coverage of health services for U.S. residents in other countries. Directs the Secretary of HEW to study the feasibility and desirability of coordinating the Federal health benefit programs for merchant seamen and Indians and Alaskan natives and also veterans and members of the Armed Forces, with the Health Security Benefit Program.
Bill· SS. 308 (94th)referred
United States · United States Congress · 21 January 1975
Extends coverage, under the supplementary medical insurance benefits program established by title XVIII (Medicare) of the Social Security Act, for one routine physical checkup, including diagnostic tests, each year and for preventive and maintenance care for individuals insured under such program.
Bill· HRH.R. 1804 (94th)referred
United States · United States Congress · 20 January 1975
Sets forth standards, relating to the rights of patients under the General Provisions of the Social Security Act, to be met by intermediate care facilities participating in programs under title XVIII (Medicare) and title XIX (Medicaid) of such Act. Provides that the statement of rights required to be adopted by such facilities shall include guarantees: (1) that the patient's civil and religious liberties will not be infringed; (2) that the patient has the right to private communications with his physician, attorney, or any other person; and (3) that the patient has the right to have privacy in treatment and in caring for personal needs and confidentiality in the treatment of personal and medical records.
Bill· HRH.R. 1792 (94th)referred
United States · United States Congress · 20 January 1975
Extends, under title XVIII (Medicare) of the Social Security Act, for an additional five years (from January 1, 1976, to January 1, 1981) the existing authority of the Secretary of Health, Education, and Welfare to grant temporary waivers of requirements for the purpose of enabling small hsopitals in rural areas to qualify under the medicare program.
Bill· HRH.R. 1805 (94th)referred
United States · United States Congress · 20 January 1975
Sets forth standards, relating to the rights of patients under the General Provisions of the Social Security Act, to be met by intermediate care facilities participating in programs under title XVIII (Medicare) and title XIX (Medicaid) of such Act. Provides that the statement of rights required to be adopted by such facilities shall include guarantees: (1) that the patient's civil and religious liberties will not be infringed; (2) that the patient has the right to private communications with his physician, attorney, or any other person; and (3) that the patient has the right to have privacy in treatment and in caring for personal needs and confidentiality in the treatment of personal and medical records.
Bill· HRH.R. 1736 (94th)referred
United States · United States Congress · 20 January 1975
Home Health Services Act - Provides, under the Public Health Service Act, for the establishment and initial operation of public and nonprofit private agencies which will provide home health services in areas in which such services are not otherwise available. Authorizes the Secretary of Health, Education, and Welfare to make grants: (1) to meet the initial and expanding costs of such agencies; and (2) for programs for the training of professional and paraprofessional personnel to provide home health services. Authorizes the appropriation of such sums as may be necessary to carry out this Act.
Bill· SS. 215 (94th)referred
United States · United States Congress · 17 January 1975
National Medical Injury Compensation Insurance Act - Adds a new title to the Public Health Service Act authorizing the Secretary of Health, Education, and Welfare to establish and implement a program of national medical injury compensation insurance. Establishes in the Treasury a Medical Injury Compensation Insurance Fund for making such payments and paying such administrative expenses as necessary for carrying out the insurance program under this Act. Stipulates that participation in the insurance program shall be conditioned upon continued compliance with specified requirements for eligibility, including agreement by the physician to review of health care services by the Professional Standards Review Organization. Provides that the insurance program established under this Act shall provide: (1) insurance benefits to insureds for compensation for loss incurred as a result of tort liability; and (2) no-fault benefits to beneficiaries of contracts entered into in accordance with the provisions of this Act for compensation for loss from any injury suffered as a result of health care services provided by an insured. States that the no-fault benefits shall consist of compensation for loss from injury determined in accordance with regulations of the Secretary, but limited to specified items, including: (1) all reasonable expenses necessarily incurred by a patient for medical and other health treatment; and (2) all reasonable expenses necessarily incurred for medical and vocational rehabilitation services. Sets forth procedures for the Secretary to follow in determining no-fault benefits. Provides for judicial review of the decisions of the Secretary. Sets time limitations on the filing of claims for no-fault benefits. Provides that no claim for no-fault benefits shall be accepted unless such beneficiary agrees, in writing, that no tort action will be instituted or prosecuted against the insured with respect to the injury for which no-fault benefits are claimed. Establishes within the Department of Health, Education, and Welfare the Medical Injury Compensation Insurance Administration. Directs the Secretary to perform the functions authorized by this Act through such Administration. Authorizes the Secretary to appoint an Advisory Council on Medical Injury Compensation. States that the Council shall advise, consult with, and make recommendations to, the Secretary with respect to: (1) the preparation of any regulations prescribed in accordance with this Act; and (2) the implementation and administration of this Act. Stipulates that in addition to no-fault benefits or tort damages, the Secretary shall, if the claimant or plaintiff was represented by an attorney, pay a reasonable fee to compensate such attorney for the services performed by him in connection with the claim or action to recover such damages. Imposes criminal penalties for falsifications made with respect to the requirements and provisions of this Act. Requires that within two years the Secretary shall develop national standards for the licensure of health professionals and prepare appropriate examinations for initial licensure and for subsequent renewal of licensure. Provides that a State may establish a program for licensure of health professionals provided it meets or exceeds the national standards.
Bill· HRH.R. 1588 (94th)referred
United States · United States Congress · 17 January 1975
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 1605 (94th)referred
United States · United States Congress · 17 January 1975
Imposes increased taxes, under the Internal Revenue Code, on cigarettes of $0.50 more per thousand on small cigarettes and $1.05 more per thousand on large cigarettes, the proceeds, coupled with additional appropriations authorizations, to be used in part for programs respecting lung and blood diseases.
Law· SS. 66 (94th)open
United States · United States Congress · 15 January 1975
Title I: Nurse Training Act - Nurse Training Act - Provides for appropriations authorizations in the areas of construction assistance under the Public Health Service Act. Authorizes assistance under such Act in the expanding of the capacities of nursing schools to provide graduate training. Extends the Financial Distress Grant Program under such Act. Authorizes the Secretary of Health, Education, and Welfare to make grants to assist public or nonprofit private schools of nursing which are in serious financial straits to meet operational costs required to maintain quality educational programs or which have special need for financial assistance to meet accreditation requirements. Provides that any such grant may be made upon such terms as the Secretary determines to be reasonable and necessary, including requirements that the school agree: (1) to disclose any financial information or data deemed by the Secretary to be necessary to determine the sources or causes of that school's financial distress; (2) to conduct a comprehensive cost analysis study in cooperation with the Secretary; and (3) to carry out appropriate operational and financial reforms on the basis of information obtained in the course of the comprehensive cost analysis study or on the basis of other relevant information. Requires the Secretary to consult with the National Advisory Council on Nurse Training in acting upon applications for grants under this title. Authorizes appropriation for such grants. Authorizes the Secretary to make grants to meet the costs of advanced nurse training programs. Authorizes appropriations for such purposes. Extends the Student Loan Program under the Act. Directs the Secretary to determine on a continuing basis: (1) the supply of registered nurses, licensed practical nurses and registered nurses with advanced training or graduate degrees, as well as other nursing personnel; (2) their distribution; and (3) the current and future requirements for such nurses. Title II: Health Revenue Sharing and Health Services: - Special Health Revenue Sharing Act - Health Revenue Sharing and Health Services Act - Authorizes the Secretary of Health, Education, and Welfare to make grants under the Public Health Service Act to State health and mental health authorities to assit in meeting the costs of providing comprehensive public health services. Family Planning and Population Research Act - Extends the appropriations authorizations for the Family Planning Programs under the Public Health Service Act. Authorizes grants for research in the biomedical, contraceptive development, behavioral, and program implementation fields related to family planning and population. Authorizes grants for planning community mental health center programs. Authorizes financial distress grants for the operation of community mental health centers. Directs the Secretary to establish within the National Institute of Mental Health a National Center for the Prevention and Control of Rape. Directs the Secretary to provide for a continuing study and investigation of: (1) the effectiveness of existing Federal, State, and local laws dealing with rape; (2) the relationship, if any, between traditional legal and social attitudes toward sexual roles, the act of rape, and the formulation of laws dealing with rape; (3) the treatment of the victims of rape by law enforcement agencies, hospitals or other medical institutions, prosecutors, and the courts; and (4) the causes of rape. Directs the Secretary to assist community mental health centers and other entities in conducting research and demonstration projects concerning the control and prevention of rape. Community Mental Health Centers Act - Requires the Secretary to formulate a five-year plan for the extension of mental health services. Revises provisions of the Public Health Service Act relating to the establishment of migrant health centers, providing highest priority for assistance in areas where the largest migratory worker populations reside. Enumerates the criteria for applications for migrant health center grants and authorizes appropriations for such grants. Defines the term "community health center" as used in this title. States that such term means an entity which, either through its staff and supporting resources or through contracts or cooperative arrangements with other public or private entities, provides: (1) primary health services; (2) as may be appropriate for particular centers, supplemental health services necessary for the adequate support of primary health services; (3) referral to providers of supplemental health services and payment, as appropriate and feasible, for their provision of such services; (4) as may be appropriate for particular centers, environmental health services, and (5) information on the availability and proper use of health services. Provides for grants for projects to plan and develop community health centers which will serve medically underserved populations and authorizes appropriations for such grants. Directs the Secretary to appoint a Committee on Mental Health and Illness of the Elderly to make a study of and recommendations respecting: (1) the future needs for mental health facilities, manpower, research, and training to meet the mental health care needs of elderly persons, (2) the appropriate care of elderly persons who are in mental institutions or who have been discharged from such institutions, and (3) proposals for implementing the recommendations of the 1971 White House Conference on Aging respecting the mental health of the elderly. Directs the Secretary to establish a temporary commission to be known as the Commission for the Control of Epilepsy and Its Consequences. Enumerates the duties of the Commission including to: (1) make a comprehensive study of the state of the art of medical and social management of epilepsy in the United States; and (2) investigate and make recommendations concerning the proper roles of Federal and State Governments and national and local public and private agencies in research, prevention, identification, treatment, and rehabilitation of persons with epilepsy. Directs the Secretary to establish a temporary commission to be known as the Commission for the Control of Huntington's Disease and Its Consequences. Makes it the duty of the Commission to: (1) make a comprehensive study of the state of the art of medical and social management of Huntington's disease in the United States; (2) investigate and make recommendations concerning the proper roles of Federal and State Governments and national and local public and private agencies in research, prevention, identification, treatment, and rehabilitation of persons with Huntington's disease; (3) develop a comprehensive national plan for the control of Huntington's disease and its consequences based on the most thorough, complete, and accurate data and information available on the disorder; and (4) transmit to the President and the Committee on Labor and Public Welfare of the Senate and the Committee on Interstate and Foreign Commerce of the House of Representatives, not later than one year after the date of enactment of this Act a report detailing the findings and conclusions of the Commission, together with recommendations for legislation and appropriations, as it deems advisable. Provides for the establishment of comprehensive hemophilia diagnostic and treatment centers and blood-separation centers.
Bill· SS. 123 (94th)referred
United States · United States Congress · 15 January 1975
Provides for the coverage of clinical psychologists' services under the supplementary medical insurance benefits program established by title XVIII (Medicare) Act.
Bill· SS. 124 (94th)referred
United States · United States Congress · 15 January 1975
New American Health Services Act - Authorizes the Secretary of Health, Education, and Welfare to make grants to the individual States for the purpose of insuring high quality comprehensive health services for immigrants residing in the United States. Provides for the establishment and support of: (1) health services projects; (2) counseling and educational programs; and (3) related evalutation efforts. Sets forth conditions which applications for grants under this Act must meet in order to receive consideration for approval. Directs that the Secretary shall not finally disapprove a State plan except after reasonable notice and opportunity for a hearing to the State. Declares that individuals who have resided in the United States for more than five years shall not be considered (aliens) immigrants for the purposes of this Act. Authorizes to be appropriated to carry out the purposes of this Act $50,000,000 for fiscal year 1976, $70,000,000 for fiscal year 1977; and $80,000,000 for fiscal year 1978.
Bill· SS. 104 (94th)referred
United States · United States Congress · 15 January 1975
Provides for inclusion of the services of licensed registered nurses under the medicare and medicaid programs of the Social Security Act.
Bill· SS. 3 (94th)referred
United States · United States Congress · 15 January 1975
Health Security Act - Title I: Health Security Benefits - Provides that every resident of the U.S. (and every non-resident citizen when in the U.S.) will be eligible for covered services. Permits reciprocal and "buy-in" agreements for groups of non-resident aliens, and in some cases benefits to U.S. residents when visiting in other countries. Entitles every eligible person to have payments made by the Health Security Board for covered services provided within the United States by a participating provider. Provides that all necessary professional services of physicians, wherever furnished are covered, including preventive care, with two important restrictions: (1) specialist services are covered only when performed by a qualified specialist except in emergency situations, and generally only on referral from a primary physician; and (2) psychiatric services to an ambulatory patient are covered only for active preventive, diagnostic, therapeutic or rehabilitative service with respect to mental illness. Provides that comprehensive dental services (exclusive of most orthodontic services) are covered for children under age 15, with the covered age group increasing by two years each year until all those under age 25 are covered. Provides that: (1) inpatient and outpatient hospital services and services of a home health agency are covered without arbitrary limitation; (2) pathology and radiology services are specifically included as parts of institutional services; and (3) custodial care is specifically excluded in specified institutional settings. Limits payment for skilled nursing home care to 120 days, except that this limit may be increased when the nursing home is owned or managed by a hospital and payment for care is made through the hospital's budget. Limits the psychiatric hospital benefit to 45 consecutive days of active treatment during a spell of illness. Provides coverage for two categories of drug use: prescribed medicines administered to inpatients or outpatients within participating hospitals; or to enrollees of comprehensive group practice organizations, and drugs necessary for the treatment of specified chronic illnesses or conditions requiring long or expensive therapy. Requires the Board and the Secretary of Health, Education, and Welfare to establish two lists of approved drugs, taking into account the safety, efficacy and cost of each drug. Provides a broad list of approved medicines available for use in institutions and by comprehensive health service organizations and a more restricted list which is available for use outside such organized settings. Provides that the appliances benefit is similar in concept and operation to the drug benefit, subject to a limitation on aggregate cost. Asserts that the professional services of optometrists and podiatrists are covered, subject to regulations, as are diagnostic or therapeutic services furnished by independent pathology laboratories and radiology services. States that health services furnished or paid for under a workmen's compensation law are not covered. Provices that the services of a professional practitioner are not covered if they are furnished in a hospital which is not a participating provider. Requires that participating providers meet standards established in this title or by the Board. Requires that such providers must agree to provide services without discrimination, to make no unauthorized charge to the patient for any covered service, and to furnish data necessary for utilization review by professional peers, statistical studies by the Board, and verification of information for payments. Makes professional practitioners, licensed when the program begins, eligible to practice in the State where they are licensed and requires that all newly licensed applicants for particiaption meet national standards established by the Board in addition to those required by his State. Establishes conditions of participation for general hospitals similar to those required under Medicare. States that the two requirements not found in the Medicare program are: (1) that the hospital must not dsicriminate in granting staff privileges on any grounds unrelated to professional qualifications; and (2) that it establish a pharmacy and drug therapeutics committee for supervision of hospital drug therapy. Provides that psychiatric hospitals will be eligible to participate only if the Voard finds that the hospital (or a distinct part of the hospital) is engaged in furnishing active diagnostic, therapeutic and rehabilitative services to mentally ill patients. Establishes conditions of participation for skilled nursing homes similar to those established for extended care facilities under Medicare. Makes provisions for the participation of home health service agencies. Describes as eligible a group practice organization which undertakes to provide an enrolled population either with complete health care or with complete health security services (other than institutional services, mental health or dental services) for the maintenance of the health and care of ambulatory patients. Permits an individual practice organization sponsored by a county or other local medical society to participate as a provider of services. Authorizes the Board to deal separately with the primary care portion of a system of comprehensive health care where it is necessary to rely on arrangements with other providers. Permits the Board to contract directly with public or other nonprofit mental health centers and mental health day care services. Specifies the broad and general conditions under which independent pathology laboratories, independent radiological services, and providers of drugs, devices, appliances, equipment, or ambulance services may qualify as providers under Health Security. Requires that a participating skilled nursing home have in effect an agreement with at least one participating hospital for the transfer of patients and medical and other information as medically appropriate. Prohibits in malpractice judgments any damages to be awarded to the injured party for the cost of remedial services which he is entitled to receive under this Act. Excludes the institutions of the Department of Defense and the Veterans Administration, and institutions of the Department of Health, Education, and Welfare serving merchant seamen or Indians or Alaskan natives, from serving as participating providers, as well as any employee of these instititions when he is acting as an employee. Provides reimbursement for any services furnished by these institutions or agencies to eligible persons who are not a part of their normal clientele. Permits a physician, dentist, optometrist, or podiatrist, licensed in one State and meeting the national standards, to furnish Health Security benefits in any other State, the scope of his permissible practice being governed by the law of the State in which he is practicing. Grants a similar authority to other health professional and nonprofessional personnel. Establishes the Health Security Trust Fund, to receive the net assets of existing (medicare) funds taken over by the Health Security program, the yield of the Health Security taxes, and the Government's contribution from general revenues amounting to 100 percent of the yield from these taxes. Provides that three separate accounts shall be established in the Health Security Trust Fund: a Health Service Account, a Health Resources Development Account, and an Administration Account. Provides that in each of the first two years of two years of the program operation, 2 percent of the Trust Fund shall be set aside for the Health Resources Development Fund; and the allocation shall increase by 1 percent at two-year intervals to 5 percent within the next 6 years. Provides for allocation of the Health Services account among the regions of the country. Provides that the allocation to each region shall be based on the aggregate sum expended during the most recent 12-month period for covered services (with appropriate modification for estimated changes in the consumer price index, the expected number of eligible beneficiaries, and estimated changes in the number of participating providers). Provides that the Board divide the allocation to each region into funds available to pay: institutional services; physician services; dental services; furnishing of drugs; furnishing of devices, applications, and equipment; and miscellaneous services. Provides that payments for covered services provided to eligible persons by participating providers will be made from the Health Service Account in the Trust Fund. Describes the method to be used in applying, as between practitioners electing the various methods of payment fee for service, the monies available in each health service area for payment to each category of professional providers. Authorizes the Board to experiment with other methods of reimbursement so long as the experimental method does not increase the cost of service or lead to overutilization or underutilization of services. Provides that skilled nursing homes and home health agencies will be paid in the same manner as a general hospital (on an approved annual budget basis). Provides that a group practice organization will be paid for covered services, on the basis of a fixed capitation rate multiplied by the number of eligible enrollees. Contains a series of provisions for developing a continuous process of health service planning and for assisting in the recruitment, education, and training of health personnel. Authorizes special improvement grants: (1) to any public or other nonprofit health agency or institution to establish improved coordination and linkages with other providers of services, and (2) to organizations providing comprehensive ambulatory care to improve their utilization review, budget, statistical, or records and information retrieval systems, to acquire equipment needed for those purposes, or to acquire equipment useful for mass screening or for other diagnostic or therapeutic purposes. Authorizes to be appropriated under the development fund part of this Act $200,000,000 beginning the fiscal year when this Act is enacted and $400,000,000 for the succeeding fiscal year. Creates an administrative structure within the Department of Health, Education, and Welfare with exclusive responsibility for administration of the Health Security program. Sets forth the responsibilities and duties of the Secretary of HEW and the Board with regard to this title. Establishes a five-member full-time Health Security Board serving under the Secretary of Health, Education, and Welfare. Provides that the members shall be appointed by the President with the advice and consent of the Senate, for five-year overlapping terms. Creates the position of an Executive Director, appointed by the Board with the approval of the Secretary. Provides that the Executive Director shall serve as secretary to the Board and shall perform such duties in the administration of the program as the Board assigns to him. Provides that the program will be administered through the regional offices of the Department of Health, Education, and Welfare. Requires the establishment of sub-regional (service area) offices. Establishes a National Health Security Advisory Council, with the Chairman of the Board serving as the Council's Chariman and 20 additional members not in the employ of the Federal Government. Authorizes the Advisory Council to appoint professional or technical committees to assist in its functions. Provides that the Advisory Council will advise the Board on matters of general policy in the administration of the program, the formulation of regulations and the allocation of funds for services. Charges the Board with responsibility for informing the public and providers about the administration and operation of the Health Security program. Requires the Board to make a continuing study and evaluation of the program, including adequacy, quality and costs of services. Authorizes the Board directly or by contract to make detailed statistical and other studies on a national, regional, or local basis of any aspect of the title; to develop and test incentive systems for improving quality of care, methods of peer review of drug utilization and of other service performances; to develop and test systems of information retrieval, budget programs, instrumentation for multiphasic screening or patient services, reimbursement systems for drugs; and to make such other studies which it considers would improve the quality of services of administration of the program. Grants authority to the Board, in accordance with regulations, to make determinations of who are participating providers of services, determinations of eligibility, of whether services are covered, and the amount to be paid to providers. Allows a provider of services who is dissatisfied with a final Board determination to obtain a hearing before a Board panel, and judicial review of a final decision. Authorizes the Board, with the advice and assistance of the Commission on the Quality of Health Care, to issue and review regulations assuring the quality of care furnished under this Act. Requires continuing professional education by physicians, dentists, optometrists, and podiatrists. Provides for the appointment of a Deputy Secretary of HEW and an Under Secretary for Health and Science. States that no provision of this Act shall alter any contractual obligation of an employer to provide health services to his employees and their dependents. Title II: Health Security Taxes - Converts the existing Medicare hospital insurance payroll taxes into Health Security taxes, and rasises the rates to 1 percent on employees and 3.5 percent on employers. Raises the wage base for the employee tax from the present $7,800 to $15,000,000 or, if higher 150 percent of the contribution and benefit base. Broadens the definitions of covered employment to include foreign agricultural workers, employees of the U.S. and its instrumentalities (other than members of the armed forces and the President, Vice-President, and Members of Congress), employees of charitable and similar organizations, railroad employees, and (for the employee tax only) employees of States and their political subdivisions and instrumentalities. Excludes from the gross income of employees, for income tax purposes, payment by their employers of part of all of the Health Security taxes on the employees. Spells out the precise effective dates of the new payroll tax provisions. Converts the existing Medicare self-employment tax into a Health Security self-employment tax, and raises the rate to 2.5 percent, and raises the maximum taxable self-employment income from $7,800 to $15,000. Adds a new 2.5 percent Health Security tax on unearned income (unless such income is less than $400 a year), subject to the same maximum on taxable income as is applicable to the employee and self-employment taxes. Title III: Commission on the Quality of Health Care - Establishes in the Department of HEW a Commission on the Quality of Health Care, with the primary responsibility of: (1) initiating and continuing development of methods of assessing the quality of health care furnished under the Health Security Act, and (2) submitting to the Secretary and the Health Security Board its findings and recommendations. Stipulates that in carrying out its duties the Commission shall emphasize, and give first consideration to, care furnished for those illnesses and conditions which have relatively high incidence in the population and which are relatively amenable to medical or other care. Title IV: Repeal or Amendment of Other Acts - Makes various conforming amendments to the medicare, medicaid vocational rehabilitation, and Federal employees health benefits statutes to bring it into conformity with this Act. Requires that after the effective date of benefits, no State shall be required to furnish any service covered under Health Security as a part of its State plan for participation under Medicaid, and that the Federal government will have no responsibility to reimburse any State for the cost of providing a service which is covered under Health Seucrity. Provides that funds available under the Vocational Rehabilitation Act or the Maternal and Child Health title of the Social Security Act shall not be used to pay for personal health services after the effective date of benefits, except (to the extent prescribed in regulations by the Secretary of HEW) to pay for services which are more extensive than those covered under Health Security. Title V: Studies Related to Health Security - Authorizes the Secretary of Health, Education, and Welfare in consulation with the Secretary of State and the Secretary of Treasury to study the coverage of health services for U.S. residents in other countries. Directs the Secretary of HEW to study the feasibility and desirability of coordinating the Federal health benefit programs for merchant seamen, and Indians and Alaskan natives, and veterans and members of the Armed Forces, with the Health Security Benefit Program.
Bill· HRH.R. 1486 (94th)referred
United States · United States Congress · 15 January 1975
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 1458 (94th)referred
United States · United States Congress · 15 January 1975
Provides an additional appropriation of $25,000,000 for fiscal year 1975, for the Department of Health, Education, and Welfare for research on the cause and treatment of diabetes.
Bill· HRH.R. 1443 (94th)referred
United States · United States Congress · 15 January 1975
National Health Service Corps Amendment - Establishes, within the Public Health Service, the National Health Service Corps to improve the delivery of health services to medically underserved populations. Directs the Secretary of Health, Education, and Welfare to designate the medically underserved populations in the States. Defines the term "medically underserved population" and enumerates the factors to be taken into account in making such designations, including: (1) ratios of available health manpower to the population; (2) indicators of the population's access to health services; and (3) indicators of health status and need of the population. Empowers the Secretary to assign Corps personnel to State health agencies, private health entities, local governments, and medical, dental or other appropriate health societies. Enumerates the requirements to be met prior to the making of any such assignments and for the continuing of expired assignments. Provides that Corps personnel shall be assigned on the basis of the extent of the population's need for health services and without regard to the ability of members of the population to pay for health services. Directs the Secretary, in making an assignment, to seek to match characteristics of the assignee and of the population in order to increase the likelihood of the assignee remaining to serve the population upon completion of his assignment period. Authorizes the Secretary to: (1) provide technical assistance to all medically underserved populations to which are not assigned Corps personnel; (2) make arrangements to enable Corps personnel to utilize the health facilities of the areas in which the population resides; and (3) make grants, with specified limitations, for purposes of providing health services. States that the Secretary shall require as a condition to the approval of an application that the entity enter into an appropriate arrangement with the Secretary under which: (1) the entity shall be responsible for charging for health services by the Corps personnel to be assigned; (2) the entity shall take action for the collection of payments for such health services; and (3) the entity shall pay to the United States specified, calculated amounts. Directs the Secretary to conduct, at schools of the health professions and allied health professions, recruiting programs for the Corps. Provides for the Secretary to adjust the monthly rate of pay of each physician and dentist member of the Corps who is directly engaged in the delivery of health services to a medically underserved population. Requires the Secretary to report annually to the Congress and specifies the content of such reports. Establishes the National Advisory Council on the National Health Service Corps to consult with, advise, and make recommendations to, the Secretary with respect to his responsibilities in carrying out this Act, and to review and approve regulations promulgated by the Secretary. Authorizes to carry out the provisions relating to the National Health Service Corps to be appropriated $30,000,000 for fiscal year 1976; $35,000,000 for fiscal year 1977; and $40,000,000 for fiscal year 1978. Requires the Secretary to: (1) report to Congress the criteria used by him in designating medically underserved populations, and the number of populations in each State meeting such criteria; and (2) conduct or contract for studies of methods of assigning National Health Service Corps personnel to medically underserved populations and of providing health care to such populations. Directs the Secretary to establish the Public Health and National Health Service Corps Scholarship Training Program to obtain trained physicians, dentists, nurses, or other health-related specialists for the National Health Service Corps or other units of the Service. Enumerates the eligibility requirements for participation in such program and the regulations governing program members. Provides that, to carry out the program, there is authorized to be appropriated $40,000,000 for fiscal year 1976; $80,000,000 for fiscal year 1977; and $120,000,000 for fiscal year 1978.
Bill· HRH.R. 1372 (94th)referred
United States · United States Congress · 14 January 1975
Revises the provisions of title XVIII (Medicare) of the Social Security Act to allow payment under the supplementary medical insurance program for optometrists' services and eyeglasses.
Bill· HRH.R. 1382 (94th)referred
United States · United States Congress · 14 January 1975
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 1381 (94th)referred
United States · United States Congress · 14 January 1975
Provides under title XI (General Provisions) of the Social Security Act that any State with a statewide Professional Standards Review Organization shall be established as one area for which a Professional Standards Reveiw Organization may be designated, if such State requests.
Bill· HRH.R. 1378 (94th)referred
United States · United States Congress · 14 January 1975
Revises the provisions of title XVIII (Medicare) of the Social Security Act to conform the timing of premium determinations thereunder with the automatic benefit increases provisions in title II (Old-Age, Survivors, and Disability Insurance) of that Act. Provides for an interim and a long- term study of malpractice insurance problems among physicians and hospitals, to be conducted by the Office of Technology Assessment.
Bill· HRH.R. 1374 (94th)referred
United States · United States Congress · 14 January 1975
Provides, under title XVIII (Medicare) and title II (Old-Age, Survivors' and Disability Insurance) of the Social Security Act, that qualified drugs requiring a physicians prescription or certification shall be included among the items and services covered under the hospital insurance program for the aged at a specified amount of payment. Establishes, within the Department of Health, Education, and Welfare, a Formulary Committee to compile and publish a Formulary listing the drugs deemed qualified for benefits under this Act, together with maximum allowable costs and additional information concerning such drugs. Makes provisions for selecting drugs for the Formulary.
Bill· HRH.R. 1373 (94th)referred
United States · United States Congress · 14 January 1975
National Catastrophic Illness Protection Act - PART A: General Provisions - Sets forth the findings of the Congress that there are still many individuals who cannot secure or cannot afford adequate health insurance protection and that very little insurance protection is available to help meet the costs of a catastrophic illness or disease. Establishes as the policy of Congress the need for a National Catastrophic Illness Insurance program to encourage State and private insurers in the development of policies which will meet the problems set forth in the statement of findings. PART B: Establishment of Program; State Plans - Authorizes the Secretary of Health, Education and Welfare to establish and carry out a National Catastrophic Illness Insurance Program. Provides that the program shall involve the creation of State-wide plans providing extended health insurance , and that the Federal Government will reinsure insurers and pools of insurers who offer such insurance. Requires all plans to include: (1) that extended health insurance be available to all eligible individuals, and at a cost which is reasonable, subject only to deductibles authorized in this Act; (2) that where an insurer does not agree to write a policy of extended insurance, or does so under various limiting conditions, the State authority is notified and provides that the policy would then be placed with a pool or otherwise assigned to insurers by the "all-industry placement facility" ; (3) that data be compiled and studied in connection with the operation of the State-wide plan; (4) that certain reports be submitted to the State insurance authority by individual insurers; (5) that any cancellation of a policy provide for reasonable notice to permit coverage under a new policy to be written under the plan; and (6) that public information about the plan be readily distributed. Sets premium rates on the basis of a study of the risks in question and actuarial principals, such rates to be promulgated by the Secretary. Provides that, before payments are made under an extended insurance policy, a deductible must be satisfied through an equal amount of medical expenses paid or incurred by such individual. Provides that the amount of such deductible is determined by relating the extent of medical expenses to adjusted income and is equal to one-half of the amount by which a person's or family's adjusted income exceeds $1,000 but does not exceed $2,000; plus all of the amount by which such adjusted income exceeds $2,000. Provides that statements pledging participation and cooperation with the State insurance authority would be required of insurers seeking reinsurance under the program. Provides that no insurer shall direct any agent or broker not to solicit business through such a plan, nor penalize agents or brokers in any manner for submitting applications under the plan. Provides that the State plan shall be evaluated from time to time in accordance with criteria established by the Secretary. PART C: Reinsurance Coverage - Provides that the Secretary is authorized to reinsure against the losses which might be incurred under extended health insurance policies. Authorizes the Secretary to make agreements with insurers and pools for reinsurance in consideration of payments of reinsurance premiums deposited in the National Catastrophic Illness Insurance Fund in excess of the estimated amount of losses under such policies. Provides a detailed procedure for implementation of the reinsurance program in a State within specified time requirements, taking into account certain State and local factors which might affect such implementation. Provides that the Government may recover in the courts any unpaid premiums lawfully payable to the Government by an insurer under provisions of a 5-year statute of limitations. PART D: Government Program with Industry Assistance - Authorizes, after determination that a State-wide program cannot be carried out, or that the objective of the program would be materially assisted by the Federal Government's assumption of the plan, arrangements for operation by the Government to carry out the objectives of the program. PART E: Provisions of General Applicability - Provides procedures for judicial review of disallowances for claims for losses under the reinsurance program whether State-wide or operated by the Federal Government. Authorizes the Government to enter into contracts and other arrangements for claims review, and receiving and disbursing funds for making payments. Provides for the creation of a National Catastrophic Illness Insurance Fund for purposes of receiving premiums for reinsurance. Provides that the Secretary may make periodic payments to insurers and pools in recognition of reduction in premium rates below estimated risks. Authorizes the Secretary of HEW to exercise certain powers vested in the Secretary of the Department of Housing and Urban Development under the Housing Act of 1950, in addition to powers provided in this proposal. Provides that the Secretary may, on a reimbursable basis, utilize the services of other Government agencies. Authorizes necessary payment adjustments in connection with the program.
Bill· HRH.R. 1366 (94th)referred
United States · United States Congress · 14 January 1975
Makes permanent the provisions regarding payments to States for training of personnel to inspect long-term care institutions pursuant to the Medicare and Medicaid provisions of the Social Security Act. Provides for publication of information on charges and the rating of such institutions. Requires such institutions to provide periodic in-service training for their nonprofessional employees in order to participate in the Medicare and Medicaid programs of the Social Security Act.
Bill· HRH.R. 1365 (94th)referred
United States · United States Congress · 14 January 1975
Provides for the establishment, under title XVIII (Medicare) of the Social Security Act, of a Nursing Home Affairs Advisory Council to advise the Secretary of Health, Education, and Welfare on ways to improve the quality of care provided by long-term care facilities receiving payments under this title or title XIX (Medicaid).
Bill· HRH.R. 1362 (94th)referred
United States · United States Congress · 14 January 1975
Provides, under the Social Security Act, for the making of grants to long-term care facilities to defray 100 percent of the reasonable cost incurred in establishing and carrying out a "rehabilitative services" for the purposes of this Act. Authorizes to be appropriated for each fiscal year the sums necessary to carry out the provisions of this Act.
Bill· HRH.R. 1361 (94th)referred
United States · United States Congress · 14 January 1975
States that as a condition of approval of a State plan under title XIX (Medicaid) of the Social Security Act, the requirement is imposed that: (1) in determining, for purposes of the administration of the State plan, the need for continued care in a particular skilled nursing facility or intermediate care facility (which provides services for which payment may be made under the State plan) of an individual who is entitled to medical assistance under the State plan, and has, for a period of 120 days or more, been an inpatient of such facility, a determination which would result in discharge or transfer from such facility shall be made only if in the judgment of a physician, after consultation with other appropriate professional personnel, such discharge or transfer would be in the best interest of such individual's physical and mental health; (2) in making such judgment and such determination proper consideration shall be given, not only to the mental and physical condition of such individual, but also to the capability of the facility to meet his particular needs, and to the impact which discharge or transfer from the particular facility would, as a practical matter, have on his general well-being in light of his age, length of stay in the facility, family situation, mental attitude, and other relevant factors; and (3) the State agency shall take appropriate affirmative action to assure that any individual discharged or transferred from a facility shall have the benefit of a planned program of information and counseling concerning such discharge or transfer designed to assist him in adjusting to the change in his care and surroundings and to minimize the personal stress which may accompany such change. Requires the Secretary of Health, Education, and Welfare to conduct, on a continuing basis in all States with plans approved under this title, investigative and oversight activities designed to determine whether there exists any basis to support a finding: (1) that the plan has been so changed that it no longer complies with the provisions of this title; and (2) that in the administration of the plan there is a failure to comply substantially with any such provision. Provides that when such activities result in observations indicating that there does exist a reasonable basis for such a finding, the Secretary shall call upon the State agency to appear at a public hearing, scheduled so as to allow reasonable notice to the State agency, to give an accounting of its administration of the plan with respect to those matters in which the Secretary has found indications of noncompliance.
Bill· HRH.R. 1354 (94th)referred
United States · United States Congress · 14 January 1975
Medicare Long-Term Care Act - Establishes within the supplementary medical insurance program under title XVIII (Medicare) of the Social Security Act a program of long-term care benefits to be provided for aged and disabled individuals and financed without additional cost to such qualified individuals from premium payments made under such Act together with contributions from funds appropriated by the Federal Government. States that every individual who is entitled to supplementary medical insurance benefits shall be entitled to the benefits of the program established by this Act. States that the benefits provided to an individual by the program established by this Act shall consist of home health services, homemaker services, nutrition services, long-term institutional care services, day care and foster home services, and community mental health center outpatient services. Provides that, to the maximum extent possible, the benefits under this Act shall be provided by or through community long-term care centers certified, monitored, and assisted, where applicable, by the State agency which performs the functions of planning, developing, and overseeing such centers. Specifies the functions of community long-term care centers, including the evaluation, certification, and administration of the services to be provided to individuals eligible for such services under this Act. Defines the terms used in this Act. States that the Secretary of Health, Education, and Welfare, after consultation with interested parties, shall develop and make available to community long-term care centers one or more methods of payment for the benefits provided and covered under this Act on a prospective basis. Authorizes the Secretary to make available the method certified by the Governor to community long-term care centers in such State if such method does not increase the cost of the program. Provides limitations on benefits in the care of eligible individuals and their spouses both claiming benefits in the same month under this Act.
Bill· HRH.R. 1308 (94th)referred
United States · United States Congress · 14 January 1975
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 1325 (94th)referred
United States · United States Congress · 14 January 1975
Waives the existing requirement, under title XIX (Medicaid) of the Social Security Act, that eligible medicaid patients be given free choice in the selection of treatment facilities in cases where the services involved are being effectively provided through locally operated public health centers, or where such services may be most effectively obtained in designated specialized medical centers.
Bill· HRH.R. 1300 (94th)referred
United States · United States Congress · 14 January 1975
Provides for the establishment, under title XVIII (Medicare) of the Social Security Act, of a Nursing Home Affairs Advisory Council to advise the Secretary of Health, Education, and Welfare on ways to improve the quality of care provided by long-term care facilities receiving payments under this title or title XIX (Medicaid).
Bill· HRH.R. 1297 (94th)referred
United States · United States Congress · 14 January 1975
States that as a condition of approval of a State plan under title XIX (Medicaid) of the Social Security Act, the requirement is imposed that: (1) in determining, for purposes of the administration of the State plan, the need for continued care in a particular skilled nursing facility or intermediate care facility (which provides services for which payment may be made under the State plan) of an individual who is entitled to medical assistance under the State plan, and has, for a period of 120 days or more, been an inpatient of such facility, a determination which would result in discharge or transfer from such facility shall be made only if in the judgment of a physician, after consultation with other appropriate professional personnel, such discharge or transfer would be in the best interest of such individual's physical and mental health; (2) in making such judgment and such determination proper consideration shall be given, not only to the mental and physical condition of such individual, but also to the capability of the facility to meet his particular needs, and to the impact which discharge or transfer from the particular facility would, as a practical matter, have on his general well-being in light of his age, length of stay in the facility, family situation, mental attitude, and other relevant factors; and (3) the State agency shall take appropriate affirmative action to assure that any individual discharged or transferred from a facility shall have the benefit of a planned program of information and counseling concerning such discharge or transfer designed to assist him in adjusting to the change in his care and surroundings and to minimize the personal stress which may accompany such change. Requires the Secretary of Health, Education, and Welfare to conduct, on a continuing basis in all States with plans approved under this title, investigative and oversight activities designed to determine whether there exists any basis to support a finding: (1) that the plan has been so changed that it no longer complies with the provisions of this title; and (2) that in the administration of the plan there is a failure to comply substantially with any such provision. Provides that when such activities result in observations indicating that there does exist a reasonable basis for such a finding, the Secretary shall call upon the State agency to appear at a public hearing, scheduled so as to allow reasonable notice to the State agency, to give an accounting of its administration of the plan with respect to those matters in which the Secretary has found indications of noncompliance.
Bill· HRH.R. 1298 (94th)referred
United States · United States Congress · 14 January 1975
Provides grants to long-term care facilities under the Social Security Act. Directs that grants defray 100 percent of the reasonable cost incurred by such facilities in establishing and carrying out a rehabilitative services program for inpatients. Authorizes appropriations for each fiscal year of such sums as are necessary to carry out the provisions of this Act. Withholds, under titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act, Federal funds from long-term care facilities which do not have in effect a rehabilitative services program.
Bill· HRH.R. 1286 (94th)referred
United States · United States Congress · 14 January 1975
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 1307 (94th)referred
United States · United States Congress · 14 January 1975
Makes changes in title XVIII (Medicare) of the Social Security Act to include postmastectomey breast prosthesis among the items and services for which payment may be made under the supplementary medical insurance program.
Bill· HRH.R. 1299 (94th)referred
United States · United States Congress · 14 January 1975
Revises title XI (General Provisions), title XVIII (Medicare), and title XIX (Medicaid) of the Social Security Act to make permanent specified provisions relating to inspections of long-term care institutions, including skilled nursing facilities. Provides for the publication of specified information regarding such institutions, and requires that such institutions provide training for their nonprofessional employees as a condition of participation in the medicare and medicaid programs.
Bill· HRH.R. 1258 (94th)referred
United States · United States Congress · 14 January 1975
Revises the Medicaid provisions of the Social Security Act to require a State, under its approved medicaid plan, to provide medical assistance (equal in amount, duration, and scope) to persons receiving aid under specified State plans and programs under the Social Security Act and to all persons eligible under the appropriate State plan.
Bill· HRH.R. 1250 (94th)referred
United States · United States Congress · 14 January 1975
Revises title XVIII (Medicare) of the Social Security Act to freeze the impatient hospital deductible which is imposed for purposes of hospital insurance benefits, and the monthly premiums which are charged for purposes of supplementary medical insurance benefits (and for purposes of hospital insurance benefits for uninsured individuals not otherwise eligible), at their 1974 levels.
Bill· HRH.R. 1249 (94th)referred
United States · United States Congress · 14 January 1975
Provides, under title XVIII (Medicare) and title II (Old-Age, Survivors' and Disability Insurance) of the Social Security Act, that eligible drugs, requiring a physicians prescription or certification, shall be included among the items and services covered under the hospital insurance program for the aged at a specified amount of payment. States that the reasonable allowance for eligible drugs furnished an individual pursuant to any one prescription and purchased by such individual at any one time shall be reduced by an amount equal to the applicable prescription copayment obligation which shall be $1. Establishes, within the Department of Health, Education, and Welfare, a Medicare Formulary Committee to compile and publish a Formulary listing the drugs deemed qualified for benefits under this Act, together with maximum allowable costs and additional information concerning such drugs. Makes provisions for selecting drugs for the Formulary.
Bill· HRH.R. 1263 (94th)referred
United States · United States Congress · 14 January 1975
Prohibits the use of appropriated Federal funds to carry out or assist research on living human fetuses which are outside of the mother's womb, and which has a beating heart.
Bill· HRH.R. 1233 (94th)referred
United States · United States Congress · 14 January 1975
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
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